WI0400033_Permit_20110418

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143,. and other _
applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kayser -Roth Corporation
FOR THE OPERATION OF 10 TYPE 5I INJECTION WELLS, defined in Title 15A North Carolina
Administrative Code 2C .0209(e)(3)(C), to inject potable water, for the in -situ chemical oxidation of
chlorinated solvents. These injection wells will be located at the Kayser -Roth Corporation Asheboro
Site, 515 W. Balfour Ave, Asheboro, Randolph County, North Carolina, and will be operated in
accordance with the permit renewal submitted July 19, 2010 and additional information submitted
January 7, 2011, and in conformity with the specifications and supporting data submitted, all of
which are filed with the Department of Environment and Natural Resources and are considered apart
of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the Water
Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an injection well .
shall be in compliance with Title 15A North Carolina Administrative Code 2C .0100 and .0200, and
any other Laws, Rules, and Regulations pertaining to well construction and use.
This permit shall be effective, unless revoked, from the date of its issuance until March 31, 2013, and
shall be subject to the specified conditions and limitations set forth in Parts I through X hereof.
Permit issued this the day of 92011.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI04(10013? PAGE I OF 6
ver.8/07 AP/MC-6

G
PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and criteria
.specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C .0200). Any
noncompliance with conditions of this permit constitutes a violation of the North Carolina Well
Construction Act and is grounds for enforcement action as provided for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection points described in the
application and other supporting data. Construction of -additional injection wells must be
approved in advance by the Aquifer Protection Section..
4. Each injection point shall not hydraulically connect separate aquifers.
5. The direct -push rig shall be secured to reasonably insure against unauthorized access and use.
6. Each injection point shall be afforded reasonable protection against damage during construction
and use. _
7. Each injection point shall be reasonably located and recorded soas to be able to accurately
identify the injection point location after abandonment.
8. Within 30 days of.completion of injection, a completed Well Construction Record (Form GW-1) .
and Well Abandonment Record (Form GW-30), Or an adequate table with all required
information, must be submitted for each injection point to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At,least forty-eight (48) hours prior to constructing each injection well, the Permittee shall notify the
Aquifer Protection Section -Underground Injection Control (UIC) Central Office staff, telephone
number [phone] and the Winston-Salem Regional Office Aquifer Protection Section Staff,
telephone number [phone].
Perinit No. WI0400033 PAGE 2 OF 6
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PART III - OPERATION AND USE GENERAL CONDITIONS
I. This permit is effective only with respect to the nature, volume of materials, rate of injection, and
number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality. (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request must
be submitted to the Director, including any supporting materials as may be appropriate, at least
30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying with
any and all statutes, rules, regulations, or ordinances which maybe imposed by other local, state,
and federal agencies which have jurisdiction. Furthermore, the issuance of this permit does not
imply that all regulatory requirements have been met.
PART IV PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there is no
contamination of groundwater which will render it unsatisfactory for normal use. In the event
that the facility fails to perform satisfactorily, including the creation of nuisance conditions or
failure of the injection zone to adequately assimilate the injected fluid, the Permittee shall take
immediate corrective actions including those actions that may be required by the Division of
Water Quality such as the repair, modification, or abandonment of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director of
any planned physical alterations or additions in the permitted facility or activity not specifically
authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for injection,
the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central Office staff,
telephone number [phone]. Notification is required so that Division staff can inspect or
otherwise review the injection facility, and. determine if it is in compliance with permit
conditions.
Pennit No. WI0400033 PAGE 3 OF 6
ver.8/07 AP/U1C-6

PART VI - INSPECTIONS
1. Any duly authorized officer, employee, or representative of the Division of Water Quality may,
upon presentation of credentials, enter and inspect any property, premises, or place on or related
to the injection facility at any reasonable time for the purpose of determining compliance with
this permit, may inspect or copy any records that must be maintained under the terms and
conditions of this permit, and may obtain samples of groundwater, surface water, or injection
fluids.
2. Department representatives shall have reasonable access for purposes of inspection, observation,.
and sampling associated with injection and any related. facilities as provided for inN .C.G.S. 87-
90. -
3. Provisions shall be made for collecting any necessary and appropriate samples associated with
the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
The proposed monitoring plan included in the application shall be followed but shall also include
samples to be taken from RWs 6 and 14. All sample results shall be submitted to the Aquifer
Protection Section's Winston-Salem Regional Office and the Raleigh Central Office. Any
monitoring (including groundwater, surface water, or soil sampling) deemed necessary by the
Division of Water Quality to insure surface and ground water protection, will be established and
an acceptable sampling reporting schedule shall be followed.
2. The Permittee shall submit an Injection Event Record within 30 days of completing each
injection. "
3. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with this permit or produce a project interim evaluation
before submitting a renewal application for this permit. This document shall assess the injection
projects findings in a written summary. The final project evaluation shall also contain
monitoring well sampling data, contaminant plume maps and potentiometric surface maps.
4. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107-2241
Permit No. W1040003,3 PAGE 4 OF 6
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5. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge of
the occurrence, to the Winston-Salem Regional Office, telephone number [phone] , any of
the following:
(A)Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
6. Where the Permittee becomes aware of an omission of any relevant facts in a permit application,
or of any incorrect information submitted in said application or in any report to the Director, the
relevant and correct facts or information shall be promptly submitted to the Director by the
Permittee.
7. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take such
immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal .use of the injection facility for the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration ,date.
PART IX - CHANGE OF WELL STATUS
1.. The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal. If a
well is not to be used for any purpose that well must -be permanently abandoned according to
15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any purpose,
the Permittee shall abandon that injection well in accordance with the procedures specified in
15A NCAC 2C .0113(b), including but not limited to the following:
(A) All casing and screen materials may m
be removed prior to initiation of abandonent
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom from
obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines that
failure to do so could lead to the contamination of an underground source of drinking
Permit No. WI040003 3, PAGE_ 5 OF 6
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water.
(D) Drilled wells shall be completely filled with cement grout, or bentonite grout which shall
be introduced into the well through a pipe which extends to the bottom of the well and is
raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely filling
it from the bottom of the casing to the top.
{F) In those cases when, as a result of the injection operations, a subsurface cavity has been
created, each well shall be abandoned in such a manner that will prevent the movement
of fluids into or between underground sources of drinking water and in accordance with
the terms and conditions of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified in
15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
1. Site access should be limited to worker's _involved in the injection of the solution. Safety
controls should be in place to ensure that the check valve and the pressure delivery systems are
working properly.
Permit No. WI04000 ' PAGE 6 OF 6
ver.8/07 AP/UIC-6

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
April 14, 2011
PERMIT ISSUANCE MEMO
TO: Debra Watts
THROUGH: Thomas Slusser
FROM: . john McCra-.
RE: Permit To Inject Potable Water
Kayser -Roth Corporation Site
I recommend that Permit Number WI0400033 be renewed for Kayser -Roth Corporation to inject potable wager to
remediate groundwater contaminated with chlorinated solvents. This permit is a renewal with modification based on
results from a pilot study conducted under the original issuance of WI0400098.
SITE DESCRIPTION The Kayser -Roth Corporation site is a textile manufacturing facility currently producing
socks. Chlorinated solvent contamination was detected in 1999. Remedial activities previously conducted consisted
of three phases of permanganate solution injection for the purpose of oxidizing contaminants found in file underlain, «
«roundwater oritainaliy permitted in, WI0400033 and subsequent re -issuances, and an injection of potable water to
assist in the dispersal of earlier injected permanganate soltitions permitted in the most recent issuance of` 10400033.
IIYDROGEOLOGIC DESCRIPTION The site is located in the Piedmont. Physiographic Province and is underlain
by bedrock of the. Carolina Slate 13- e1t. The site is underlain by up to 88 feet of residual silt anti clay overlying
metamorphosed volcaniclastle rock of the liwharrie Formation. • Within the confines of the site, the depth to
groundwater ranges from 19 feet bas to 37 feet bgs. Groundwater within the saprolite flows to the southeast across
the site udder a hydraulic gradient of 0.018ft/ft through an aquifer that has an effective porosity of 25°3,o with a
hydraulic conductivity of 0.1.9ft/day, allowinct the water to flow at an estimated rate of 0.8 feet per day. Groundwater
within the fractured bedrock flows to the east-southeast across the site under a hydraulic gradient of 0.028ft/it through
an aquifer that has an effective porosity of 8% with a hydraulic conductivity of 1.9ft/day, allowing the water to flow at
an estimated rate of 0.67 feet per day.
EXTENT OF CONTAMINATION Figures 3 and 4 show the lateral extent of contamination across the site
within the saprolite and bedrock zones. Depth of contamination based on the deepest recovery well screen interval is
estimated to be 1.10 'feet. The areal extent of the -plume has receded since the initial injection of pennanganate
solution but has consistently rebounded after each injection event. An. extensive network of structural fractures within.
the saprolite and bedrock. apparently serve as a source of residual contamination in groundwater over time.
PROPOSED INJECTION The Applicant proposes to inject a total of 6,000 gallons of potable water into the
underlying saprolitic aquifer through as many as ten (10) direct -push injection points at moderate (150-200 psi)
pressure at a rate of up to 10 gpm. The total volume of the injectant is consistent with the previous permit issuance
and does not appear to present any problem.
NOW IT WORKS The remedial process of potassium permanganate is by oxidation of PCE. Contaminant
rebound due to matrix release. of adsorbed contaminants retards the effectiveness of the injectant and can isolate the
oxidizing solution in the immediate vicinity of the injection. This process can be countered by injecting water into the
aquifer to move the oxidizing solution out of the immediate area of the injection zone.

MONITORING Subsequent groundwater monitoring will be conducted according to the plan set forth in the
previous issuance of permit W10400033. The plan will consist of sampling eighteen wells and analyzing the samples
for VOCs as well as a select number of those wells for constituents that are indicators of the oxidation process
(Additional information response dated January 7, 2011).
EPIDEMIOLOGY Injection consists of potable water.
REGIONAL OFFICE COMMENTS Sliuying Wan- of the Winston-Salem Regional Office recommends issuance of "
this permit with consideration of further information.

I`
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
August 1, 2007
MEMORANDUM
TO: Debra Watts
THROUGH: Qu Qi
FROM: Peter Pozzo Sad /
SUBJECT: Injection well permit renewal for Kayser -Roth Corporation
Type 5I Permit No. WI0400033
Randolph County
The subject permit renewal request has been received for the injection of potassium
permanganate to oxidize dissolved tetrachloroethene (PCE) contamination at this site.
After each injection there appears to be some rebound in the contaminant levels so the
Permittee has requested to continue injection. After reviewing the application package, I
recommend issuance of the permit.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION -
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kayser -Roth Corporation
FOR THE CONSTRUCTION AND OPERATION OF TYPE 5I INJECTION WELLS, defined
in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(C), to inject potassium
permanganate, to oxidize dissolved chlorinated solvent contamination.. These injection
wells/points will be located at Kayser -Roth Corporation Asheboro Sock Facility, 515 West
Balfour Avenue, Asheboro, Randolph County, North Carolina, and will be operated in
accordance with the application submitted September 16, 2002 and modification request
submitted September 29, 2004 and renewal April 5, 2067; and in conformity with the -
specifications and supporting data submitted June 1, 2007, all of which are filed with the
Department of Environment and Natural Resources and are considered apart of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until August 31,
2009, and shall be subject to the specified conditions and limitations set forth in Parts I through
X hereof. This permit replaces and supersedes the permit issued January 15, 2007
Permit issued this the i,c 0' day of -4— , 2007.
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400033 PAGE 1 OF 7
ver.6/07 AP/UIC-6

PART I -,WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during
construction and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL: CONDITIONS
1. At least forty-eight (48) hours prior to constructing_ each injection well, the Permittee shall
notify the Aquifer. -Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number [phone] and the Winston-Salem Regional Office Aquifer
Protection Section Staff, telephone number [phone].
Permit No. WI0400033 PAGE 2 OF 7
ver.6/07 AP/UIC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature; volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The. issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances which may be imposed by other
local, state, and federal agencies which have jurisdiction. Furthermore, the issuance of this
permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the .operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned physical alterations or additions in the permitted facility or activity not
specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone number (919) 715-[reviewer number]. Notification is required so that
Division staff can inspect or otherwise review the injection facility and determine if it is in
compliance with permit conditions.
Permit No. WI0400033 PAGE 3 OF 7
ver.6/07 AP/UIC-6

PART VI - INSPECTIONS
Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S.87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. 'Monitoring wells MW-1, MW-3, MW-6b, MW-8, MW-10b, MW-12, MW-17, MW-21,
DW-2, AND DW-3 shall be sampled by the following schedule:
Analysis
Pre -Injection
Three and Six
Months after
Injection
Semi -Annual
(There After)
Volatile Organic Compounds
X
X
X
Chloride
X
X
X
Manganese
X
X
X
Chromium
X
X
X
pH
X
X
X
Temperature
X
X
X
Conductivity
X
X
X
Oxidation Reduction Potential
X
X
X
Dissolved Oxygen
X
X
X
2. All sample results shall be submitted to the Aquifer Protection Section's Winston-Salem
Regional Office and the Raleigh Central Office.. Any monitoring (including groundwater,
surface water, or soil sampling) deemed necessary by the Division of Water Quality to insure
surface and ground water protection, will be established and an acceptable sampling reporting
schedule shall be followed.
3. The Permittee shall submit an Injection Event Record within 30 days of completing each
inj ection.
Permit No. WI0400033 PAGE 4 OF 7
ver.6/07 AP/UIC-6

4. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with the permit application. This document shall assess
the injection projects findings in a written summary. The, final project evaluation shall. also
contain monitoring well sampling data, contaminant plume maps and potentiometric surface
maps.
5. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UTC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winsto-Salem Regional Office
585 Waughtowri Street
Winston-Salem, NC 27107
6. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
of the occurrence, to the Winston-Salem Regional Office, telephone number [phone],
any of the following:
(A) Anyoccurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
7. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
8. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
In order to continue uninterrupted legal use of the injection facility for.the stated purpose, the
Permittee must submit an application to renew the permit 120 days prior to its expiration date.
Permit No. WI0400033 PAGE 5 OF 7
ver.6107 APIUIC-6

PART IX - CHANGE OF WELL STATUS .
The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the. discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facilityand a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0113(b), including but not limited to the following:
(A) All casing and screen materials maybe removed prior to initiation of abandonment
procedures'if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed_ to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to do so could lead to the contamination of an underground source of
drinking water.
(D)Drilled wells shall be completely filled with cement grout, or bentonite grout which
shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G) The Penn ittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
.DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Permit No. WI0400033 PAGE 6 OF 7
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f
PART X — WORKER PRECAUTIONS DURING APPLICATION
Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat and lung irritation. If the product is released into, the environment in a
way that could result in a suspension of fine solid or liquid particles (e.g., grinding, blending,
vigorous shaking or mixing), then proper personal protective equipment should be used. The
application process should be reviewed by an industrial hygienist to ensure. that the most
appropriate personal protective equipment is used.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. Face and body protection should be used for anticipated splashes or
sprays.
3. This product may cause spontaneous ignition with cloth or paper. Caution should be taken to
prevent spills on clothes. Also, this product could react violently with most metal powders,
ammonia, ammonia salts, phosphorus, finely divided organic compounds, flammable liquids
and sulfur. 'In addition, this productmay become explosive if mixed with sulfuric acid, acetic
acid, or acetic anhydride if not kept cold.
4. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
5. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
6. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0400033 PAGE 7 OF 7
ver.6/07 AP/UIC-6

DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
December 30, 2004
MEMORANDUM
TO: Debra Watts J
THROUGH: Evan KaneClk
FROM: Mike Ranck/11P
SUBJECT: Injection well permit amendment for Kayser -Roth Corporation
Type 5I Permit No. WI0400033
Randolph County
The subject permit amendment request has been received for the injection of potassium
permanganate to oxidize dissolved tetrachloroethene (PCE) contamination at this site.
After reviewing the application package, I recommend issuance of the permit. A
summary of my review follows:
Site Overview: A permit was issued on January 9, 2003 for the pilot -scale injection of
a potassium permanganate solution at the subject site. The pilot test has been
completed. Monitoring results showed lowered PCE concentrations initially, but PCE
levels have rebounded to original levels in many monitor wells. The purpose of the
permit amendment is to allow the additional injection of higher concentration
potassium permanganate slurry to address residual source area contamination. The
higher concentration will provide a higher oxidation potential over a longer time
period.
2. Injection: Potassium permanganate oxidizes PCE, creating the following by-products:
carbon dioxide, manganese dioxide, potassium, and chloride. The concentration of
potassium permanganate in the proposed slurry (30-35%) is much higher than pilot
test solution concentrations (1-3%). Injection will occur in 10-12 borings
(approximately 100 gallons slurry per boring) to be installed near MW-10b in the
same area where pilot test injections were performed. Injection interval will be the
shallow saturated saprolite zone near the water table.
3. Monitoring: Monitoring will occur immediately following injection, three months
following injection, six months following injection, and semi-annually thereafter at
10 monitoring wells. Wells are located upgradient, downgradient, and within the
injection area. Sampling parameters are sufficient to monitor the injection, and
include DO, ORP, pH, specific conductance, chloride, manganese, chromium, and
PCE.
4. Epidemiology: Dr. Luanne Williams has evaluated the health risks of permanganate
and did not identify any concerns that would prohibit injection.
O
Based on the remarks presented above, I recommend issuance of this permit. If you have
any questions, please let me know.

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF WELLS FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kayser -Roth Corporation
FOR THE CONSTRUCTION AND OPERATION OF TYPE 5I INJECTION WELLS, defined
in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(C), to inject potassium
permanganate to oxidize dissolved chlorinated solvent contamination. These injection
wells/points will be located at 515 West Balfour Avenue, Asheboro, North Carolina, and will be
operated in accordance with the application submitted September 16, 2002 and modification
request submitted September 29, 2004, and in conformity with the specifications and supporting
data submitted, all of which are filed with the Department of Environment and Natural Resources
and are considered a part of this permit.
This permit is for Construction and Operation only, and does not waive any provisions of the
-; Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until January 31,
2007, and shall be subject to the specified conditions and limitations set forth in Parts I through
X hereof. This permit replaces and supersedes the permit issued January 9, 2003.
Permit issued this the �� day of Jt-
& , 2005.
��— Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400033 PAGE 1 OF 7
ver.7/04 AP/UIC-6

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided for
in N.C.G.S.87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. This permit is valid only for construction of the number of injection wells described in the
application and other supporting data. Construction of additional injection wells must be
approved in advance by the Aquifer Protection Section.
4. Each injection well shall not hydraulically connect separate aquifers.
5. Each injection well shall be constructed in such a manner that water from land surface cannot
migrate into the gravel pack or well screen.
6. Each injection well shall be secured to reasonably insure against unauthorized access and use.
Each well shall be permanently labeled with a warning that it is for injection purposes and the
entrance to each well must be secured with a locking cap.
7. Each injection well shall be afforded reasonable protection against damage during
construction and use.
8. Each injection well shall have permanently affixed an identification plate.
9. Within 30 days of completion of well construction, a completed Well Construction Record
(Form GW-1) must be submitted for each injection well to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
1. At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Aquifer Protection Section -Underground Injection Control (UIC) Central Office
staff, telephone number [phone] and the Winston-Salem Regional Office Aquifer
Protection Section Staff, telephone number [phone].
Permit No. WI0400033 PAGE 2 OF 7
ver.7/04 AP/UIC-6

PART III - OPERATION AND USE GENERAL CONDITIONS
1. This permit is effective only with respect to the nature, volume of materials, rate of injection,
and number of injection wells as described in the application and other supporting data.
2. This permit is not transferable without prior notice. to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be appropriate,
at least 30 days prior to the date of the change.
3. The issuance of this permit shall not relieve the Permittee of the responsibility of complying
with any and all statutes, rules, regulations, or ordinances which may be imposed by other
local, state, and federal agencies which have jurisdiction. Furthermore, the issuance of this
permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
1. The injection facility shall be effectively maintained and operated at all times so that there is
no contamination of groundwater which will render it unsatisfactory for normal use. In the
event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit even if
compliance requires a reduction or elimination of the permitted activity.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the Director
of any planned physical alterations or additions in the permitted facility or activity not
specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Aquifer Protection Section-UIC, Central
Office staff, telephone number [phone]. Notification is required so that Division staff
can inspect or otherwise review the injection facility and determine if it is in compliance with
permit conditions.
Permit No. WI0400033 PAGE 3 OF 7
ver.7/04 AP/UIC-6

PART VI - INSPECTIONS
Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained under
the terms and conditions of this permit, and may obtain samples of groundwater, surface
water, or injection fluids.
2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided for
in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. The proposed monitoring plan included in the application shall be followed. All sample
results shall be submitted to the Aquifer Protection Section's Winston-Salem Regional Office
and the Raleigh Central Office. Any monitoring (including groundwater, surface water, or
soil sampling) deemed necessary by the Division of Water Quality to insure surface and
ground water protection, will be established and an acceptable sampling reporting schedule
shall be followed.
2. The Permittee shall produce a final project evaluation within 9 months after completing all
injection -related activity associated with the permit application. This document shall assess
the injection projects findings in a written summary. The final project evaluation shall also
contain monitoring well sampling data, contaminant plume maps and potentiometric surface
maps.
3. The monitoring results and the final project evaluation shall be submitted to:
and to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Aquifer Protection Section
DENR-DWQ Winston-Salem Regional Office
585 Waughtown Street
Winston-Salem, NC 27107
4. The Permittee shall report by telephone, within 48 hours of the occurrence or first knowledge
Permit No. WI0400033 PAGE 4 OF 7
ver.7/04 AP/UIC-6

of the occurrence, to the Winston-Salem Regional Office, telephone number 336-771-4600,
any of the following:
(A) Any occurrence at the injection facility which results in any unusual operating
circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility incapable of
proper injection operations, such as mechanical or electrical failures.
5. Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to the
Director by the Permittee.
6. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall take
such immediate action as may be required by the Director.
PART VIII - PERMIT RENEWAL
The Permittee shall, at least 120 days prior to the expiration of this permit, request an
extension.
PART IX - CHANGE OF WELL STATUS
1. The Permittee shall provide written notification within 15 days of any change of status of an
injection well. Such a change would include the discontinued use of a well for injection. If a
well is taken completely out of service temporarily, the Permittee must install a sanitary seal.
If a well is not to be used for any purpose that well must be permanently abandoned
according to 15A NCAC 2C .0113, Well Construction Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0113(b), including but not limited to the following:
(A) All casing and screen materials may be removed prior to initiation of abandonment
procedures if such removal will not cause or contribute to contamination of the
groundwaters.
(B) The entire depth of each well shall be sounded before it is sealed to insure freedom
from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director determines
that failure to do so could lead to the contamination of an underground source of
drinking water.
(D) Drilled wells shall be completely filled with cement grout, or bentonite grout which
Permit No. WI0400033 PAGE 5 OF 7
ver.7/04 AP/UIC-6

shall be introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have not been
removed, neat -cement, or bentonite grout shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface cavity has
been created, each well shall be abandoned in such a manner that will prevent the
movement of fluids into or between underground sources of drinking water and in
accordance with the terms and conditions of the permit.
(G)The Permittee shall submit a Well Abandonment Record (Form GW-30) as specified
in 15A NCAC 2C .0213(h)(1) within 30 days of completion of abandonment.
3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Aquifer Protection Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat and lung irritation. If the product is released into the environment in a
way that could result in a suspension of fine solid or liquid particles (e.g., grinding, blending,
vigorous shaking or mixing), then proper personal. protective equipment should be used. The
application process should be reviewed by an industrial hygienist to ensure that the most
appropriate personal protective equipment is used.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. Face and body protection should be used for anticipated splashes or
sprays.
3. This product may cause spontaneous ignition with cloth or paper. Caution should be taken to
prevent spills on clothes. Also, this product could react violently with most metal powders,
ammonia, ammonia salts, phosphorus, finely divided organic compounds, flammable liquids
and sulfur. In addition, this product may become explosive if mixed with sulfuric acid, acetic
acid, or acetic anhydride if not kept cold.
4. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
5. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
Permit No. WI0400033 PAGE 6 OF 7
ver.7/04 AP/UIC-6

6. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0400033 PAGE 7 OF 7
ver.7/04 AP/UIC-6

GROUNDWATER SECTION
December 31, 2002
MEMORANDUM
To: Debra Watts, Supervisor, Permits & Compliance Branch
From: Mark Pritzl, Hydrogeological Technician, UIC Program
Re: Kayser-Roth's injection well application for a pilot study to inject potassium
permanganate to oxidize the dissolved chlorinated solvent contamination.
This site is located within the Carolina Slate Belt of Late Proterozoic age rocks that include
volcanic and sedimentary sequences which have been metamorphosed. There are also a
variety of plutons that intrude into these metamorphic volcanic and sedimentary sequences.
Specifically, this site is underlain by the Uwharrie Formation, which consists mainly of
felsic metavolcanic rocks. The residual soils at this site consist of red -brown clayey silts
grading into a tan, yellow -brown and green -gray clayey silt saprolite and partially weathered
rock. A hard weathered rock to a more competent bedrock is encountered at depths ranging
from approximately 24 to 75 feet below grade at this site.
Shallow groundwater, or the surficial aquifer at this site occurs within the saprolite soils and
partially weathered bedrock. At the pilot study injection area, shallow groundwater
movement is toward the south but groundwater movement grades to the east as one moves
east from the proposed Phase I injection area. Bedrock groundwater, or the bedrock aquifer
at the pilot study injection area also moves east into a potentiomentric low spot or trough.
There is a measured vertical gradient with depth at this site indicating shallow groundwater
is recharging the deeper bedrock aquifer. There are no surface water bodies within 2,000
feet of the injection area.
• Chlorinated solvent contamination exist both in the surficial and bedrock aquifers with PCE
as the main chlorinated solvent contaminant of concern. Thk proposed uilot study injection
w' 1 take lace in both aquifers with the ma'ority of ction into the surficial aquifer.
l • . GeoProbe holes and existing monitoring wells will be used to inject a potassium
permanganate solution. This solution will consist of 24% potassium permanganate and
potable water.
I have provided a very simple flow chart to explain the different injection and monitoring
procedures for this pilot study. Phase I will be considered unsuccessful if the GeoProbe can
not be utilized for injection purposes. If the GeoProbe can not be used during Phase I, then
injection into monitoring wells MW-3, MW-10b, MW-11, AM-13, MW-17 and DW-1 will
not occur until Phase Ilb. If Phase I is successful, then the Phase I post -injection monitoring
at two months will be conducted just prior to Phase Ila injection activities.

Injection box
Monitoring box
..................................................................
IlVDEX
Phase I pre -injection
monitoring:
• New monitoring
wells, MW-10c &
MW-23
Pre -injection samples from;
MW-1, MW-6b, MW-8,
MW-10c, MW-12, MW-21
& DW-2
• pH, specific cond.,
cr, Mn, Cr
• VOCs for MW-10c
& MW-23
Two months then Phase Ila injection:
Additional 10 to 20 GeoProbe points to 40 foot depth &
MW-3, MW-10b, MW-11, MW-13, MW-17 & DW-1
Phase 1 successful
Phase 1 injection wells:
6 to 8 GeoProbe points to 40 foot depth &
MW-3, MW-10b, MW-11, MW-13, MW-17 & DW-1
If Phase 1 is unsuccessful,
then no Phase I post -
injection monitoring
Phase I post -injection
monitoring:
post -injection samples from;
MW-1, MW-6b, MW-8, MW-10c,
MW-12, MW-21 &.DW-2
One week: pH, specific cond., Cr, Mn,
Cr
One month: pH, specific cond., Cl
Mn, Cr
Two months: pH, specific cond., Cl-,
Mn, Cr & all VOCs EPA method 8260
Phase IIb post -injection monitoring:
Phase IIa post-
inj ection, monitoring:
One month:
Samples from all MWs at
site for, pH, specific cond.,
Cl-, Mn, Cr & all VOCs
EPA method 8260
Four months:
from.MW-1, MW-6b,
(MW-8, MW-10c, MW-12,
11 MW-21 & DW-2'f6r pH, -`
specific cond., Cl , Mn, Cr
Seven months:
1-1
From all s4 except
injection wells, for all'
parameters
One week:
from MW-1, MW-6b, MW-8, MW-10c, MW-12, MW-21 & DW-2 for pH, specific conu:,
Cl-, Mn, Cr
Two months:
from MW-1, MW-6b, MW-B, MW-10c, MW-12, MW-21 & DW-2 for pH, specific coed.,
One month then Phase IIb injection: Cr, Mn, Cr & all VOCs EPA method 8260
Five months:
Three open borehole injections & from MW-1, MW-6b, MW-8, MW-10c, MW-12, MW-21 & DW-2 for pH, specific cond.,
MW-3, MW-IOb, MW-11, MW-13, MW-17 & DW-1 Cr, Mn, Cr
Eight Months:
From��MWs, except injection wells, for all parameters

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH, NORTH CAROLINA
PERMIT FOR THE CONSTRUCTION AND OPERATION OF A WELL FOR INJECTION
In accordance with the provisions of Article 7, Chapter 87; Article 21, Chapter 143, and
other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Kayser -Roth Corporation
FOR THE CONSTRUCTION AND OPERATION OF A TYPE 5I INJECTION WELL, defined
in Title 15A North Carolina Administrative Code 2C .0209(e)(3)(C), for a pilot study to inject
Potassium Permanganate to oxidize the dissolved chlorinated solvent contamination 515 West
Balfour Avenue, in Asheboro, North Carolina, and will be operated in accordance with the
application received on September 16, 2002 and in conformity with the specifications and
supporting data submitted, all of which are filed with the Department of Environment and
Natural Resources and are considered apart of this permit.
'This permit is for Construction and Operation only, and does not waive any provisions of the
Water Use Act or any other applicable Laws, Rules, or Regulations. Operation and use of an
injection well shall be in compliance with Title 15A North Carolina Administrative Code 2C
.0100 and .0200, and any other Laws, Rules, and Regulations pertaining to well construction and
use.
This permit shall be effective, unless revoked, from the date of its issuance until January 31,
2006, and shall be subject to the specified conditions and limitations set forth in Parts I through
X hereof.
Permit issued this the day of , 2003.
Ted L. Bush, Jr., Assistant Chief
Groundwater Section
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit No. WI0400033 PAGE 1 OF 6
ver.3/01 GW/UIC-5

PART I - WELL CONSTRUCTION GENERAL CONDITIONS
1. The Permittee must comply with all conditions of this permit and with the standards and
criteria specified in Criteria and Standards Applicable to Injection Wells (15A NCAC 2C
.0200). Any noncompliance with conditions of this permit constitutes a violation of the
North Carolina Well Construction Act and is grounds for enforcement action as provided
for in N.C.G.S. 87-94.
2. This permit shall become voidable unless the facility is constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data.
3. Each injection well shall not hydraulically connect separate aquifers.
4. Each injection well shall be constructed in such a manner that water from land surface
cannot migrate into the gravel pack or well screen.
Each injection well shall be secured to reasonably insure against unauthorized access and
use. Each well shall be permanently labeled with a warning that it is for injection purposes
and the entrance to each well must be secured with a locking cap.
6. Each injection well shall be afforded reasonable protection against damage during
construction and use.
7. Each injection well shall have permanently affixed an identification plate.
8. A completed Well Construction Record (Form GW-1) must be submitted for each injection
well to, DENR-Division of Water Quality, Groundwater Section UIC-Staff, 1636 Mail
Service Center, Raleigh, NC 27699-1636, within 30 days of completion of well
construction.
PART II - WELL CONSTRUCTION SPECIAL CONDITIONS
At least forty-eight (48) hours prior to constructing each injection well, the Permittee shall
notify the Groundwater Section -Underground Injection Control (UIC), Central Office staff,
telephone number [phone].
PART III - OPERATION AND USE GENERAL CONDITIONS
This permit is effective only with respect to the nature, volume of materials and rate of
injection, as described in the application and other supporting data.
2. This permit is not transferable without prior notice to, and approval by, the Director of the
Division of Water Quality (Director). In the event there is a desire for the facility to change
ownership, or there is a name change of the Permittee, a formal permit amendment request
must be submitted to the Director, including any supporting materials as may be
appropriate, at least 30 days prior to the date of the change.
Permit No. WI0400033 PAGE 2 OF 6
ver.3/01 GW/UIC-5

I _ i
3. The issuance of this permit shall not relieve the Permittee of the responsibility of
complying with any and all statutes, rules, regulations, or ordinances which may be
imposed by other local, state, and federal agencies which have jurisdiction. Furthermore,
the issuance of this permit does not imply that all regulatory requirements have been met.
PART IV - PERFORMANCE STANDARDS
The injection facility shall be effectively maintained and operated at all times so that there
is no contamination of groundwater which will render it unsatisfactory for normal use. In
the event that the facility fails to perform satisfactorily, including the creation of nuisance
conditions or failure of the injection zone to adequately assimilate the injected fluid, the
Permittee shall take immediate corrective actions including those actions that may be
required by the Division of Water Quality such as the repair, modification, or abandonment
of the injection facility.
2. The Permittee shall be required to comply with the terms and conditions of this permit
even if compliance requires a reduction or elimination of the permitted activity.
1 The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwater resulting from the operation of this facility.
PART V - OPERATION AND MAINTENANCE REQUIREMENTS
1. The injection facility shall be properly maintained and operated at all times.
2. The Permittee must notify the Division and receive prior written approval from the
Director of any planned physical alterations or additions in the permitted facility or activity
not specifically authorized by the permit.
3. At least forty-eight (48) hours prior to the initiation of the operation of the facility for
injection, the Permittee must notify by telephone the Groundwater Section -Underground
Injection Control (UIC), Central Office staff, telephone number [phone].
Notification is required so that Division staff can inspect or otherwise review the injection
facility and determine if it is in compliance with permit conditions.
PART VI - INSPECTIONS
Any duly authorized officer, employee, or representative of the Division of Water Quality
may, upon presentation of credentials, enter and inspect any property, premises, or place on
or related to the injection facility at any reasonable time for the purpose of determining
compliance with this permit, may inspect or copy any records that must be maintained
under the terms and conditions of this permit, and may obtain samples of groundwater,
surface water, or injection fluids.
Permit No. WI0400033 PAGE 3 OF 6
ver.3/01 GW/UIC-5

2. Department representatives shall have reasonable access for purposes of inspection,
observation, and sampling associated with injection and any related facilities as provided
for in N.C.G.S. 87-90.
3. Provisions shall be made for collecting any necessary and appropriate samples associated
with the injection facility activities.
PART VII - MONITORING AND REPORTING REQUIREMENTS
1. The proposed monitor plan included in the application received on September 16, 2002
shall be followed and all sample results shall be submitted to the Groundwater Section's
Winston-Salem Regional Office and the Raleigh Central Office. Any monitoring
(including groundwater, surface water, or soil sampling) deemed necessary by the Division
of Water Quality to insure surface and ground water protection, will be established and an
acceptable sampling reporting schedule shall be followed.
2. The Permittee shall produce a final project evaluation within 9 months after completing
all injection activity associated with your permit application. This document shall assess
the injection proj ect's findings in a written summary. The final project evaluation shall
also include all monitoring well sampling data, the contaminant plume maps and the
potentiometric surface maps.
3. The final project evaluation shall be submitted to the Underground Injection Control
Program; Groundwater Section, NC DENR-Division of Water Quality, 1636 Mail Service
Center, Raleigh, NC 27699-1636 and to the Groundwater Section, Winston-Salem
Regional Office, 585 Waughtown Street, Winston-Salem, NC 27107.
4. The Permittee shall report by telephone, within 48 hours of the occurrence or first
knowledge of the occurrence, to the Winston-Salem Regional Office, telephone number
[phone], any of the following:
(A) Any occurrence at the injection facility which results in any unusual
operating circumstances;
(B) Any failure due to known or unknown reasons, that renders the facility
incapable of proper injection operations, such as mechanical or electrical
failures.
Where the Permittee becomes aware of an omission of any relevant facts in a permit
application, or of any incorrect information submitted in said application or in any report to
the Director, the relevant and correct facts or information shall be promptly submitted to
the Director by the Permittee.
6. In the event that the permitted facility fails to perform satisfactorily, the Permittee shall
take such immediate action as may be required by the Director.
Permit No. WI0400033 PAGE 4 OF 6
ver.3/01 GW/UIC-5

PART VIII - PERMIT RENEWAL
The Permittee shall, at least three (3) months prior to the expiration of this permit,
request an extension.
PART IX - CHANGE OF WELL STATUS
The Permittee shall provide written notification within 15 days of any change of status of
an injection well. Such a change would include the discontinued use of a well for
injection. If a well is taken completely out of service temporarily, the Permittee must
install a sanitary seal. If a well is not to be used for any purpose that well must be
permanently abandoned according to 15A NCAC 2C .0213(h)(1), Well Construction
Standards.
2. When operations have ceased at the facility and a well will no longer be used for any
purpose, the Permittee shall abandon that injection well in accordance with the procedures
specified in 15A NCAC 2C .0214, including but not limited to the following:
(A) All casing and materials may be removed prior to initiation of
abandonment procedures if the Director finds such removal will not be
responsible for, or contribute to, the contamination of an underground
source of drinking water.
(B) The entire depth of each well shall be sounded before it is sealed to insure
freedom from obstructions that may interfere with sealing operations.
(C) The well shall be thoroughly disinfected, prior to sealing, if the Director
determines that failure to do so could lead to the contamination of an
underground source of drinking water.
(D) Drilled wells shall be completely filled with cement grout, which shall be
introduced into the well through a pipe which extends to the bottom of the
well and is raised as the well is filled.
(E) In the case of gravel -packed wells in which the casing and screens have
not been removed, neat -cement shall be injected into the well completely
filling it from the bottom of the casing to the top.
(F) In those cases when, as a result of the injection operations, a subsurface
cavity has been created, each well shall be abandoned in such a manner
that will prevent the movement of fluids into or between underground
sources of drinking water and in accordance with the terms and conditions
of the permit.
(G) The Permittee shall submit a Well Abandonment Record (Form GW-30)
as specified in 15A NCAC 2C .0213(h)(1) within 30 days of completion of
abandonment.
Permit No. WI0400033 PAGE 5 OF 6
ver.3/01 GW/UIC-5

3. The written documentation required in Part IX (1) and (2) (G) shall be submitted to:
Groundwater Section-UIC Staff
DENR-Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
PART X — WORKER PRECAUTIONS DURING APPLICATION
1. Some effects reported to be associated with the product proposed to be used are as follows:
eye, skin, nose, throat and lung irritation. If the product is released into the environment in
a way that could result in a suspension of fine solid or liquid particles (e.g., grinding,
blending,. vigorous shaking or mixing), then proper personal protective equipment should
be used. The application process should be reviewed by an industrial hygienist to ensure
that the most appropriate personal protective equipment is used.
2. Persons working with these products should wear goggles or a face shield, gloves, and
protective clothing. Face and body protection should be used for anticipated splashes or
sprays.
3. This product may cause spontaneous ignition with cloth or paper. Caution should be taken
to prevent spills on clothes. Also, this product could react violently with most metal
powders, ammonia, ammonia salts, phosphorus, finely divided organic compounds,
flammable liquids and sulfur. In addition, this product may become explosive if mixed
with sulfuric acid, acetic acid, or acetic anhydride if not kept cold.
4. Eating, drinking, smoking, handling contact lenses, and applying cosmetics should not be
permitted in the application area during or immediately following application.
5. Safety controls should be in place to ensure that the check valve and the pressure delivery
systems are working properly.
6. The Material Safety Data Sheets should be followed to prevent incompatible or adverse
reactions and injuries.
Permit No. WI0400033 PAGE 6 OF 6
ver.3/01 GW/UIC-5

0'
MW-5 1
le MW-1 Saprolite Unit Monitoring Well
W" DW-1 Bedrock Unit Monitoring Well 1
Proposed Monitoring Well Location 1
r Proposed Phase I and IIa Direct -Push 11 ► MW-12
d Boring Injection Area 1
d Proposed Phase IIb Air Rotary 1
Open -Hole Injection Point Location 1
1 MW-] 1 O
1 ,r
1
1 MW-4
MW-10c O `�
1 DW-4 �
1 '
MW-13 ? 1 Ga .MW-10b
Main
1 Plant
MW-17 6* 1 0 Building
1 p MW-6b
MW-8
1
1
MW-21 �.
Ll
1
: Proposed Additional MW-3 a MW-2b r
Saprohte Well Location
150'to South Across ❑
West Bailey Street 11 DW-1
MW-20 f 1
DW-5 1
1
1 DW-2 -7 ,.
1 � lam►
1' DW-3
1 MW-1
Trailer Park 1
1
1
1
1
1
1
1
1
1
1
1
1
Fence
1
Burrrvl Road (SR 1500)
Author Drawing Layer Date Title
Duneklee & Dunham`' , P.. dmr 02600-1 0,10 12-10-01 Proposed Injection and Monitoring Locations
Job No. Revision Figure Scale Project Burlington / Kayser -Roth Project
Environmental Consultants 02600 5-28-02 9 1"-- 100'
Asheboro, North Carolina

Legend
a` MW-1 Saprolite Unit Monitoring Well
DW-1 Bedrock Unit Monitoring WellProposed
Monitoring Well LocationProposed
r�M�W-12
Phase I and IIa Direct -Push
Boring Injection Area
Proposed Phase IIb Air Rotary
Open -Hole Injection Point Location
MW-21
�e Proposed Additional
Saprolite Well Location
150'to South Across
West Bailey Street
cn
MW 3
E
�1 DW-1
MW-20 , f
1
iZ
DW-5
1
1 DW-2
1 MW-1
Trailer Park I —
i
i
0
Bum Road (SR 1500)
t— Fence
1
MW-5 `�
,0�
Main
Plant
Building
MW-2b f
[:1
r
DW-3
Author Drawing Layer Date Title
Duneklee &Dunham, P.C. dmr 02600-1 0,10 12_10.O
Proposed Injection and Monitoring Locations
n
Job No. Revision Figure Scale Project Burlington /Kayser -Roth Project
Environmental Consultants 02600 5-28-02 9 1"=100' Asheboro, North Carolina